Individual provider · NPI-1

Meron W Addisu, LCSW

Social Worker, Clinical · Paramus, NJ

NPI number1316572001
StatusActive
Last updated in NPPESMay 2, 2023

Details

NPI
1316572001
Entity type
Individual (NPI-1)
Name
Ms. Meron W Addisu
Credential
LCSW
Sex
Female
Sole proprietor
No
Enumeration date
Mar 3, 2020
Certification date
May 2, 2023
Last updated
May 2, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1041C0700X Social Worker, Clinical44SC06199000NJYes
104100000X Social Worker44SL05882500NJ

Practice location

300 Forest Ave
Paramus, NJ 07652-5429

Phone 201-680-1420

Mailing address

86 Warren St Apt 3b
Nutley, NJ 07110-2343

Phone 201-680-1420

Other practice locations

650 Bloomfield Ave Ste 106
Bloomfield, NJ 07003-2542

Phone 973-744-6522

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